Key Priorities for young people in the new system Dr. Ann Hoskins National Programme Director (Children, Young People and Families) Public Health England

2 There are 5 million year olds in England Marmot and others showed that a poor start in life can reduce achievement in childhood and in adult life Evidence base and emerging science of brain development show we can make a difference through early intervention and public health approaches There are economic and social arguments for investing in young people to minimise costs to society in later years and maximise potential of individuals Many poor health outcomes for adults originates when we are young, for example smoking, mental health, obesity and violence Why Young People matter

3 Children, Young People and Families: Life course approach Marmot 2010, Fair Society, Healthy Lives: The Marmot Review

ONS – Measuring National Well-being Programme 2011/ year olds 89% reported a relatively high level of satisfaction with life overall 94% report a high level of satisfaction with their family 73% reported having a meal with their family 3 or more times a week 82% were relatively satisfied with their school 4

ONS – Measuring National Well-being Programme 2011/12 16 – 19 year olds 84% reported a relatively high level of satisfaction with life overall 66% reported low anxiety yesterday 75% reported they were satisfied with their health 82% were relatively satisfied with their school 16 – 24 year olds 21.4% unemployed, a rise since 2003 Almost 12% had been victims of crime 10.9% report a long term illness or disability 5

Young people admitted to hospital HES data July June 2013, HSCIC 2.5m episodes for children 0-19 Most common primary diagnoses for children years / years : abdominal and pelvic pain Over 9 years of age; Girls more likely self harm (5% year olds), Boys assault (2% year olds) 6Presentation title - edit in Header and Footer

Positive Trends & Inequalities 7Presentation title - edit in Header and Footer

Under 18 conception rate | England Approximately 3% (29,000) of teenage girls conceived in Nationally, the rate has fallen by 34%, from around 47 conceptions per 1,000 population in 1998, to its 2011 level of approximately 30 conceptions per 1,000 population. 8

9 Blackpool: 58.1 Rutland: fold variation between best and worst areas Under 18 conception rate per 1,000 female population aged 15 to 17 years in England Office for National Statistics; map: Child and Maternal Health Intelligence Network

10 Smoking, drinking and drug use Smoking, drinking and drug use among young people in England in

11 Alcohol use among young people in England, % of pupils had drunk alcohol, a decrease from the peak of 61% in % of pupils had drunk alcohol in the last week compared to 26% in % of pupils said they usually drank at least once a week, compared with 20% in 2001 Drinking alcohol in the last week is associated with age, ethnicity, and other risky behaviours (smoking, drug taking and truancy) The Health and Social Care Information Centre 2012

12 Substance Use Among Students in 36 European Countries ESPAD 2011 UKEuropean Average Alcohol use last 30 days65%57% Heavy episodic drinking past 30 days 52%39%

Public Health England’s Mission 13 “To protect and improve the nation’s health and to address inequalities, working with national and local government, the NHS, industry, academia, the public and the voluntary and community sector.”

Our priorities for 2013/14 14 –Sets out Public Health England’s priorities and actions for the first year of our existence –Five outcome-focused priorities – what we want to achieve –Two supporting priorities – how we will achieve it –27 key actions to take now –The start of the conversation – a three-year corporate plan will follow

Outcome-focused priorities 15 1.Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol 2.Reducing the burden of disease and disability in life by focusing on preventing and recovering from the conditions with the greatest impact, including dementia, anxiety, depression and drug dependency 3.Protecting the country from infectious diseases and environmental hazards, including the growing problem of infections that resist treatment with antibiotics 4.Supporting families to give children and young people the best start in life, through working with health visiting and school nursing, family nurse partnerships and the Troubled Families programme 5.Improving health in the workplace by encouraging employers to support their staff, and those moving into and out of the workforce, to lead healthier lives

Supporting priorities 16 6.Promoting the development of place-based public health systems 7.Developing our own capacity and capability to provide professional, scientific and delivery expertise to our partners

Actions 2013/ Giving children and young people the best start in life Launch a national programme promoting healthy weight and tackling childhood obesity Partner the Troubled Families programme Accelerate improvements in child health outcomes Partner the Early Intervention Foundation

Children, Young People and Families are everywhere in PHE’s Priorities and Actions 18

Actions 2013/14 (extracts) 19 1.Reducing preventable deaths Accelerate efforts to promote tobacco control & reduce the prevalence of smoking Report on premature mortality and the Public Health Outcomes Framework 2.Reducing the burden of disease Improve recovery rates from drug dependency Improve sexual health and reduce the burden of sexually transmitted infections Develop a national programme on mental health in public health

Actions 2013/14 (extracts) 20 3.Protecting the country’s health Reverse the current trends so that we reduce the rates of tuberculosis infections Lead the gold standards for current vaccination and screening programmes Develop and implement a national surveillance strategy 6.Promoting place-based public health systems Make the business case for promoting wellbeing, prevention and early intervention as the best approaches to improving health and wellbeing Partner NHS England to maximise the NHS’ impact on improving the public’s health Implement the public health workforce strategy and develop the PHE workforce

Early Intervention and the Public Health Outcomes Framework 21

Public Health Outcomes Framework Under 18 conceptions Low birth weight of term babies – teenage mums Breast feeding Smoking status at time of delivery 22 Health improvement Outcomes improved by early intervention

Public Health Outcomes Framework Health protection Population vaccination coverage especially for children Healthcare Infant mortality Tooth decay in children Under 75 mortality CVD Suicide rate 23 Health protection / Healthcare Outcomes improved by early intervention

Public Health Outcomes Framework School readiness First time entrants to the justice system year olds not in education, employment or training 24 Wider determinants of health Outcomes improved by early intervention

Place-based approach to public health 25 Public health advice Health and wellbeing boards Local government CCGs PHE centre NHSE area team EPPR Screening and immunisation Offender public health programmes Specialised commissioning Primary care public health programmes and population healthcare NHS providers Non- statutory providers* People and communities *Including voluntary and community sector

Children, Young People and Families 26 Life Course approach PregnancyEarly YearsSchool-agedAdolescents Reduce numbers of still births and infant deaths Safe transfer of Healthy Child Programme 0-5s Settings approach – healthy schools and FE Reaching C&YP out of school NCMP Adolescent public health improvement framework – targeting children & young people with multiple vulnerabilities Corporate priority Improving health outcomes Healthy weight and tackling childhood obesity Troubled Families Early Intervention Cross- cutting Reduce number of children under 18 killed in road traffic accidents Promote resilience/ improve mental health and wellbeing Ensure children, young people & families shape, inform and hold PHE to account Life-stage priority

How can we make a difference? Use knowledge about risk and what builds resilience Promote evidence and learning from practice about what works Combine targeted help for those most at risk with universal interventions Take a life course and place-based approach –schools, families, and communities Work in partnership, taking a coordinated and collaborative approach, recognising strengths of different partners and using resources effectively Listen and act on what children, young people and carers tell us 27

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